Thanks to a recent decision by the 9th U.S. Circuit Court of Appeals that lifts an outdated ban on payments for bone marrow, the thousands of children and adults whose lives depend on receiving a transplant of bone marrow now have a much greater chance of receiving one.

But in an unbelievable twist, the Obama administration is urging that this case be reheard and the ruling overturned. The administration argues that allowing payment for bone marrow would privilege the wealthy at the expense of the poor and sick, as well as undermine Congress’ “clear policy of encouraging voluntary bone marrow donations.”
Not only are these arguments wholly out of touch with how people receive their health care in America, they also show a cruel disregard for the plight of those desperately needing bone marrow.

The administration’s first argument is that the ruling will turn bone marrow into an expensive luxury obtainable only by the wealthy. Yet most medical goods and services today are not paid in full directly out of a patient’s pocket; instead, they’re covered by a third party such as private insurance or a government payer such as Medicare. Bone marrow will be no different.

The administration also claims that the ruling will exploit the poor, as they undertake a painful and risky health procedure in order to receive compensation. Yet the court addressed this very issue when it recognized that bone marrow is now usually extracted in a manner very similar to how blood plasma is taken from donors. Just as it does with blood plasma, the human body will naturally replenish the extracted bone marrow. The court realized that given the strong similarities between blood plasma donation and bone marrow donation, since it is legal to pay for blood plasma, it should be legal to pay for bone marrow.

The purchase of blood plasma for around $40 a visit does not exploit the poor — this is why it is legal. Since this is so, it should be obvious that the far greater payments proposed for bone marrow donors (MoreMarrowDonors.org has suggested that they be compensated with $3,000 worth of scholarships, gifts to charities or housing allowance) cannot possibly be exploitative, either.

The administration’s next contention — that allowing payment for bone marrow would exploit the sick — would be laughable if it did not have such potentially deadly consequences. Payments for bone marrow will save the lives of the sick by making more bone marrow become available for transplants. This isn’t exploitation — it’s basic human decency.

If the attorney general’s ultimate objection to allowing payment for bone marrow is that it would undermine Congress’ “clear policy of encouraging voluntary bone marrow donations,” then perhaps Congress needs a different policy. To let people die to satisfy the ideological commitments of people in Washington is horribly and appallingly wrong.

In 1991, Time magazine featured on its cover Marissa Ayala, a newborn who was conceived and born expressly to provide bone marrow to her sister, Anissa, dying of leukemia and in need of a marrow transplant to survive.

Today, Anissa is cancer-free. Thousand more could have that opportunity if the decision from the 9th Circuit Court of Appeals is allowed to stand.

James Stacey Taylor is an associate professor of philosophy at the College of New Jersey.